The purpose of this study is to evaluate the efficacy of tracheal suctioning associate with expiratory pause maneuver in children on invasive mechanical ventilation.
After being informed about the study and potential risks, all parents or guardians giving written informed consent will be evaluate for study entry. Children in invasive mechanical ventilation who meet eligibility criteria will be submitted of two techniques of tracheal suctioning (with and without expiratory pause maneuver), randomized in a crossover trial in a 1:1 ratio, for determine the first technique to be applied. Clinical data will be collected (sex, age, presence of previous disease, diagnosis of hospitalization), as well as the ventilatory parameters (ventilation mode, peak inspiratory pressure, positive end-expiratory pressure, tidal volume, respiratory frequency, fraction of inspired oxygen). The protocol consists of an initial conventional tracheal suctioning with a negative pressure of 40mmHg for all the participants. After two (2) hours the first technique will be applied and an interval of another two hours for the application of the second technique. Respiratory mechanics and hemodynamic parameters will be evaluate before and after 30 minutes of each tracheal suctioning techniques. In case of clinical alterations that may aggravate the patients condition during the protocol (oxygen saturation \< 85%, heart rate \> 190bpm and/or decrease 20% of mean arterial blood pressure), the technique will be interrupted immediately and the patient will be evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
10
Perform closed endotracheal suctioning with an expiratory pause of 5 seconds
Perform closed endotracheal suctioning without expiratory pause
Hospital de Clínicas de Porto Alegre
Porto Alegre, Rio Grande do Sul, Brazil
Weight of endotracheal suctioning
Weight of endotracheal suctioning in milligrams
Time frame: Immediately after suctioning
Peak inspiratory pressure
Peak inspiratory pressure in centimeters of water (cmH2O)
Time frame: Baseline and 30 minutes
Plateau pressure
Plateau pressure in centimeters of water (cmH2O)
Time frame: Baseline and 30 minutes
Tidal volume
Tidal volume in milliliters (ml)
Time frame: Baseline and 30 minutes
Dynamic compliance
Dynamic compliance in milliliters per kilograms per centimeters of water (mL/kg/cmH2O)
Time frame: Baseline and 30 minutes
Airway resistance
Inspiratory and expiratory resistance in centimeters of water per liter (cmH2O/L)
Time frame: Baseline and 30 minutes
Auto-positive end-expiratory pressure (auto-PEEP)
Auto-PEEP in centimeters of water (cmH2O)
Time frame: Baseline and 30 minutes
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